Low serum leptin serves as a biomarker of malnutrition in elderly patients

Anthropometric and classical biologic markers of malnutrition, such as serum albumin, are limited because they are influenced by nonnutritional factors. We propose that a biologic parameter that both predicts nutritional status and is unaffected by nonnutritional factors would facilitate the diagnosis of malnutrition in the elderly. This cross-sectional study included 179 randomized elderly patients. Nutritional status was assessed by the Mini-Nutritional Assessment (MNA) instrument; other end points included anthropometric measures and biologic parameters. Subjects were divided into 3 groups based on MNA-defined nutritional status, and end point means were compared using 2-way analyses of variance adjusted by sex. Correlations between the most accurate biologic marker in predicting malnutrition and other biologic and clinical variables were assessed using Pearson correlation test. Multiple linear regressions were then performed to relate the best biomarker of malnutrition to specific parameters. Finally, leptin levels that predict malnutrition were determined using receiver operating characteristic curve cutoff values. The well-nourished group had significantly higher leptin (P = .001), weight, body mass index, mid-arm circumference, and calf circumference (all, P < .001) compared with the malnourished group and the at risk of malnutrition group. Serum leptin was the optimal biomarker of MNA-defined malnutrition and had significant positive correlations with weight (P = .003) and with all anthropometric values (all P < .001), but no significant correlation with C-reactive protein. Sex, weight, and triglyceride were the best predictors of serum leptin (all P < .001). The optimal cutoff value of serum leptin to detect malnutrition was 4.3 ng/mL in men and 25.7 ng/mL in women. Serum leptin may be a good predictor of nutritional status in elderly patients.     

创伤应激后的脂肪代谢

创伤后脂肪代谢的特点是消化吸收障碍、肝脏摄取减少、脂肪动员、肝脏输出、肝外组织摄取、脂肪氧化产能、甘油三酯水解-再酯化循环增加等,这些变化机制与交感神经兴奋、胰岛素抵抗和炎症反应有关,使脂肪取代葡萄糖成为主要能源物质.补充葡萄糖可以抑制脂肪氧化但不能抑制脂肪水解和再酯化,补充长链脂肪乳能预防必需脂肪酸缺乏,补充胆固醇能促进脂肪乳吸收和利用.通过干预脂肪代谢,有望改善创伤的预后.     

艾炷灸对动脉粥样硬化兔总胆固醇和三酰甘油含量的影响

目的观察艾炷灸对动脉粥样硬化(AS)兔总胆固醇(TC)、三酰甘油(TG)水平的影响。方法将60只新西兰大耳白兔通过高脂饲料喂养及免疫损伤法建立兔AS模型,然后随机分为空白组(空白对照组)、模型组(AS模型组)、艾炷灸组(AS模型+艾炷直接灸)、西药组(AS模型+阿托伐他汀),每组15只。运用酶法测定各组大鼠TC、TG含量的变化。结果艾炷灸和西药均能降低AS兔血清中TC、TG的含量。结论艾炷灸对TC、TG的代谢具有良好的调节作用。     

别样茶降血脂研究进展

别样茶（Non—CamelliaTeas）是一类具有悠久的应用历史和应用传统,不属于山茶科（Theaceae）山茶属（Camellia）,迄今在民间仍广泛作茶饮的植物。现代化学研究表明,别样茶富含黄酮类、茶多酚、氨基酸、生物碱等多种化合物;现代药理和临床研究证明别样茶具有降压、降血脂、降糖、抗氧化等作用,是预防慢性代谢性疾病的很好的研究对象。通过查阅大量文献对别样茶降血脂方面进行了整理,此文从别样茶降血脂的化学成分及降血脂作用的机理进行阐述,为别样茶降血脂方面的深入研究和开发提供一定的参考。     

A refined-JinQi-JiangTang tablet ameliorates prediabetes by reducing insulin resistance and improving beta cell function in mice

Ethnopharmacological relevance

Refined-JQ (JQ-R) is a mixture of refined extracts from three major herbal components of JinQi-JiangTang tablet: Coptis chinensis (Ranunculaceae), Astragalus membranaceus (Leguminosae), and Lonicera japonica (Caprifoliaceae). Our previous studies have indicated that JQ-R could decrease fasting blood glucose levels in diabetic mice and insulin resistance mice. Investigating the hypoglycemic effect of JQ-R on prediabetes has practical application value for preventing or delaying insulin resistance, impaired glucose tolerance and possibly the development of clinical diabetes.

Materials and methods

The anti-diabetic potential of JQ-R was investigated using a high fat-diet (HFD)-induced obesity mouse model. C57BL/6J mice (HFD-C57 mice) were fed with high-fat diet for 4 months. HFD-C57 mice were treated with either JQ-R (administered intragastrically once daily for 4 weeks) or metformin (as positive control), and the effects of JQ-R on body weight, blood lipids, glucose metabolism, insulin sensitivity, and beta cell function were monitored.

Results

The body weight, serum cholesterol, and the Homeostasis Model Assessment ratio (insulin resistance index) were significantly reduced in JQ-R or metformin-treated mice, and the glucose tolerance was enhanced and insulin response was improved simultaneously. Moreover, both JQ-R and metformin could activate liver glycogen syntheses even under a relatively high glucose loading. Although glyconeogenesis was inhibited in the metformin treated mice, it was not observed in JQ-R treated mice. Similar to metformin, JQ-R could also improve the glucose infusion rate (GIR) in hyperglycemic clamp test. JQ-R was also shown to increase the levels of phosphorylated AMPKα and phosphorylated acetyl CoA carboxylase (ACC), similar to metformin.

Conclusion

JQ-R could reduce HFD-induced insulin resistance by regulating glucose and lipid metabolism, increasing insulin sensitivity through activating the AMPK signaling pathway, and subsequently improving β cell function. Therefore, JQ-R may offer an alternative in treating disorders associated with insulin resistance, such as prediabetes and T2DM.     

In vitro effects of active components of Polygonum Multiflorum Radix on enzymes involved in the lipid metabolism

Ethnopharmacology relevance

Raw and processed Polygoni Multiflori Radix (PMR and PMRP) are used in the prevention and treatment of non-alcoholic fatty liver disease (NAFLD), hyperlipidemia or related diseases. In our previous research, 2, 3, 5, 4′-tetrahydroxy-stilbene-2-O-β-d-glucoside (TSG) displayed the most important role in the total cholesterol (TC) lowering effect among all the chemical constituents of Polygonum multiflorum. Emodin and physcion displayed more favorable triglyceride (TG) reducing effects than TSG. However, there are few researches focus on the approach and mechanism of how do Polygonum multiflorum exhibit good lipid regulation activity. The targeted sites of active substances of Polygonum multiflorum are still not clearly elucidated. This research pays close attention to how major chemical components of Polygonum multiflorum affect the TC and TG contents in liver cells.

Materials and methods

In this research, a sensitive, accurate and rapid in vitro model, steatosis hepatic L02 cell, was used to explore target sites of active chemical substances of Polygonum multiflorum for 48 h. Steatosis hepatic L02 cell was exposed to emodin, physcion and TSG, respectively. The contents of four key enzymes in the pathway of synthesis and decomposition of TC and TG were investigated after exposure. Meanwhile, the contents of lipid transfer protein were also tested. The diacylgycerol acyltransferase 1 (DGAT1) controlled the biosynthesis of TG from free fatty acids while 3-hydroxy-3-methyl-glutaryl-CoA reductase (HMG-CoA reductase) limited the biosynthesis of TC. Hepatic triglyceride lipase (HTGL) and cholesterol 7α-hydroxylase (CYP7A) played the key role in the lipolysis procedure of TG and TC.

Results

The synthesis of TC and TG in steatosis L02 cells were apparently increased in the model group compared to the control group. Intracellular contents of HMG-CoA reductase and DGAT1 increased 32.33% and 56.52%, while contents of CYP7A and HTGL decreased 21.61% and 47.37%. Emodin, physcion and TSG all showed down-regulation effects on HMG-CoA reductase, while up-regulation effects on CYP7A. The most remarkable effect on HMG-CoA reductase was found on emodin. Emodin could reduce the DGAT1 content from 438.44±4.51 pg/mL in model group to 192.55±9.85 pg/mL (100 μm). The content of HTGL in 300 μm physcion group was 3.15±0.15 U/mL, which was more significantly effective than the control, lovastatin and fenofibrate group.

Conclusions

TSG could raise the content of CYP7A and then promote the lipolysis of cholesterol. Moreover, TSG also showed the best LDL-reducing effect. Emodin could inhibit HMG-CoA reductase and DGAT1, which were key enzymes in the synthesis of TC and TG. Physcion increased the content of HTGL, and then could boost the lipolysis of triglyceride. At the same time, physcion showed the best VLDL-reducing effect. In view of the above conclusions, we contributed the lipid regulation activity to an overall synergy of TSG, emodin and physcion.     

不同剂量铜摄入对大鼠血脂影响

目的 探讨铜摄入量对大鼠血脂的影响,为定量评价铜引发动脉粥样硬化(atherosc lerosis,AS)的危险性提供数据基础.方法 选择Wistar大鼠饲以缺铜饲料并给予不同剂量葡萄糖酸铜30 d,分析铜摄入量与大鼠体内总胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)等血脂指标关系.结果 铜摄入量≤0.047 mg/kg时,大鼠血中ApoB为0.31~0.35 g/L、LDL-C为0.37~0.43 mmol/L,2者均高于正常对照水平,差异有统计学意义(P<0.05);铜摄入量≤0.175 mg/kg时,大鼠血中TG为1.28~1.53 mmol/L,高于正常对照水平,差异有统计学意义(P<0.05);铜摄入量为4.015 mg/kg时,ApoA1为(0.12±0.02)g/L,高于正常对照,差异有统计学意义(P<0.05).结论 铜摄入量异常可不同程度对大鼠各项血脂指标产生影响,进而对AS的发生与发展产生促进或抑制作用.     

结构脂肪乳剂与物理混合中长链脂肪乳剂在危重症患者中的临床应用

目的比较结构脂肪乳和物理混合的中/长链脂肪乳剂在危重症患者营养支持治疗中的疗效。方法 61例短期内不能耐受肠内营养和存在肠内营养禁忌的危重症患者分为结构脂肪乳(STG)组和中/长链脂肪乳(MCT/LCT)组,给予肠外营养支持,观察血浆蛋白、脂质代谢、血糖变化等。结果①胃肠外营养(PN)支持治疗5d后,STG组获得正氮平衡,其结果与MCT/LCT组比较,差异有显著性意义(P<0.05),STG组前白蛋白的增高可更好地促进蛋白合成。②STG组患者予肠外营养支持5d后与输注前比较其甘油三酯和胆固醇水平差异无显著性(P>0.05)。但MCT/LCT组血脂水平变化有显著性差异(P<0.05)。③对血糖影响差异无显著性(P>0.05)。结论不耐受肠内营养和存在肠内营养禁忌的危重症患者应用结构脂肪乳进行肠外营养是安全和有效的,在改善氮平衡,促进蛋白质合成方面优于物理混合的中/长链脂肪乳剂,且对血脂影响较小。     

2型糖尿病家系一级亲属血脂分析

目的 研究2型糖尿病家系一级亲属血脂的变化规律.方法 以37个2型糖尿病家系中的一级亲属（n=98）为受试者,按照OGTT结果分为3组：糖耐量正常（NGT）组（n=61）、糖调节受损（IGR）组（n=22）和糖尿病（DM）组（n=15）,并以正常体检者为对照组（n=39）.分别检测及比较各组血清总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）水平.结果 3个受试组TG水平均高于对照组（NGT组、IGR组与对照组比较,均P〈0.05;DM组与对照组比较,P〈0.01）,而TC、LDL-C及HDL-C水平的差异均无统计学意义.结论 2型糖尿病家系一级亲属血脂代谢紊乱,主要表现为TG升高.